I recently graduated in medicine from Townsville, Australia, and I still enjoy writing blogs on medicine and pharmacy-related topics. I appreciate writing about my experience on different placements or topics I'm interested in. As English is my second language, writing blogs is a hobby and a fun challenge!


My Book Review on The Tall Man — Death and Life on Palm Island.

My Book Review on The Tall Man — Death and Life on Palm Island.

 
“If you talk to a man in a language he understands, that goes to his head. If you talk to him in his language, that goes to his heart.”
— Nelson Rolihlahla Mandela
 
 

Preface

This is my book review on The Tall Man written by Chloe Hooper. I decided to open with a short description of the book and then talk about issues that involved the Indigenous population in Australia. This includes problems that occurred in the past to the common present challenges in society.

Introduction

The Tall Man – Death and Life on Palm Island by Chloe Hooper essentially boils down to Mr Mulrunji Doomadgee, an Indigenous person, found dead in custody on the cold prison cell floor where Mr Chris Hurley, a non-Indigenous person, was the police officer in charge. A series of events on Palm Island, that are tied beyond generations, led to that unfortunate outcome. Throughout the book, there is a stark contrast between the Indigenous and non-Indigenous people as if the incident was a metaphor of the struggle in Australia during the past, present and surely – the future. Whilst reading I felt completely divided and segregated constantly; developed vs developing, high SES(†) vs low SES, right vs wrong, missionary vs the lawless, whites vs blacks, not guilty vs buried, us against them – an apartheid, just like in South Africa but more modern and invisible.

“No Land meant no Dreaming, and no Dreaming meant no identity, no meaning.” ~ Extract from The Tall Man, Chapter 1, The Family.

Aboriginal and Torres Strait Islanders have a very powerful bond and a sense of belonging in their culturally owned land and is a pillar of their ways of life. During ‘The Wild Times’ and colonisation, this feeling of belonging and connection with the land was ripped apart as segregation, relocation and assimilation occurred. It left me to wonder; how can a population so deep-rooted with its spiritual beliefs, cultural existence, sacred ritualistic ties to the land and integral ceremonies with customary songs heal if they have been forbidden to speak their mother tongue and cut off from their expressional ceremonies? Passing down knowledge and culture to younger generations is paramount, and was severed. This had a huge impact on the Indigenous population, especially regarding their health, life expectancy, incidence, prevalence, morbidity, and mortality as we are still seeing today in the medical community. These impacts greatly affect the psychosocial risk factors(‡) and social capital characteristics(§) which has a profound effect on the Indigenous people. This, ironically, replaces culture through the generations. Whilst reading and researching I realised the Indigenous people on Palm Island is a perfect example of how these risk factors affect them due to their past and present treatment, leading to an unprecedented amount of suicide rate, diabetes mellitus, obesity, ears and eyes infections, renal failure, sexually transmitted infections especially syphilis, substance abuse and lung disease (4-11).

“Nation’s Child Abuse Shame.” ~ Headline from The Australian (12) whilst Mr Hurley is waiting for his trial to resume.

The SES, psychosocial risk factors and social capital characteristics were moulded due to the past and are the reasons for the fruits of the present. The Northern Territory National Emergency Response occurred for a reason after all. The marginalised Indigenous population, where men were collectively and unjustly accused of sexual child abuse, were further isolated, abandoned and vilified (13). This was a justly cause to valiantly save the “Little Children are Sacred” with implementations that were poorly performed and fed from pre-existing concepts and out-of-touch understanding of the Indigenous population. It was shocking to see a government-led initiative with such a rapid intervention that had limited consultation to the communities and that initially applied to only Aboriginal people. This speaks volumes on how the Indigenous population are still being treated in 2007 (14). Hence, from the colonisation impact in Australia, it has been shown that there are poorer health-care outcomes due to ethnically and racially biased clinical decision making in the past and present, with unequal distribution of healthcare affecting the already disadvantaged (15). Current day medical practice needs to understand the differences between Indigenous and typical western culture, so we do not misidentify, misdiagnose and mistreat.

As a result of the identified need for cultural recognition in the medical space, the National Aboriginal and Islander Health Organisation (NAIHO) was created in 1971 to close the gap in Indigenous health (15). Later becoming NACCHO, they are committed to serve with a strong relationship, respect for financial disadvantage, government backing and an increase in Indigenous clinical staff. It has been proven in 2017 to be clinically effective, with a 23% improvement in retention and attracting Indigenous patients instead of mainstream providers (16-18). This is a presence that is being felt in the Northern Territory and on Palm Island as Aboriginal and Torres Strait Islander Health Workers are making a positive difference by building a stronger relationship between Indigenous culture and Western health.

There has been some evident reconciliation as observed in recent events. This July there was progress regarding the stolen wages movement as the Queensland government will pay out 190 million dollars to Indigenous workers who have been fighting for withheld wages (19). Tens of thousands of Indigenous workers, including the workers on Palm Island, throughout the 1880s to 1970s (mainly in the cattle industries) were underpaid during this time. Ironically, the farmers and the industries were heavily dependent on the vulnerable workers who were exploited (19). Just like on Palm Island, the ‘Protector’ will decide on the Indigenous wages and how they are spent. The Indigenous population revolted against the government and won (only in Queensland so far), similarly to how Elizabeth Doomadgee had to deal with the death of her brother in a dominantly white and prejudiced judiciary system in ‘The Tall Man’.

In the end, an apology with compensation was issued but to what cost (16)? A father and his son died, and the closest justice outcome came about 12 years later with the perpetrator being not guilty. I always wondered how quick and swift justice would be if it was the other way around. However, Australia is healing and learning from its mistakes and past actions. Reforms are being made in a positive outcome, communities are being consulted and ran by elders and there is a general consensus of moving forward. The road will be long, tedious and twisted with challenges and barriers but as a nation, it can be done.

 
 
“A nation’s greatness is measured by how it treats its weakest members.”
— Mohandas Karamchand Gandhi

Published 30th August 2019. Last reviewed 1st December 2021.

 

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Footnotes

 Socioeconomic status (SES) refers to the social and economic position of a given individual, or group of individuals, within the larger society (1). These include age, education, ethnicity, gender, occupation, income, employment, religion and housing (2).

 Psychosocial risk factors are defined by Loughry and Eyber as ‘pertaining to the influence of social factors on an individual’s mind and behaviour, and to the interrelation of behavioural and social factors’ (3). These include poor social networks, low self-esteem, self-efficacy, psychological distress, anxiety, insecurities, loss of sense of control, high physical and psychological demand, chronic stress, isolation, anger/hostility, coping and perception/expectations (2).

§ Social capital refers to the community and societal characteristics (2). These includes poverty, crime rate, domestic violence, unemployment rate, income inequality, residence (rural, urban, remote), altruism, philanthropy and volunteering work, trust in people and social institutions, civic and political involvement and empowerment, social and community participation, tolerance of diversity, social networks and support structures (2).

Reference

1. Australian Bureau of Statistics. Measures of Socioeconomic Status. Australian Bureau of Statistics website. http://www.ausstats.abs.gov.au/Ausstats/subscriber.nsf/0/367D3800605DB06CA2578B60013445C/$File/12440 55001_2011.pdf Published June 22, 2011. Accessed April 21, 2019.

2. Victoria State Government. The Victorian happiness report. Victoria State Government website. https://www2.health.vic.gov.au/about/publications/ResearchAndReports/victorian-happiness-report. Published 2015. Accessed April 25, 2019.

3. Loughry M, Eyber C. Psychosocial Concepts in Humanitarian Work with Children: A Review of the Concepts and Related Literature. Washington (DC): National Academies Press (US); 2003.

4. Australian Early Development Census. Hinchinbrook community. Australian Early Development Census website. https://www.aedc.gov.au/data/data-explorer?id=138343. Published 2018. Accessed April 2, 2019.

5. Australian Bureau Statistics. Palm Island (S) (LGA) (35790). Australian Bureau Statistics website. https://itt.abs.gov.au/itt/r.jsp?RegionSummary&region=35790&dataset=ABS_REGIONAL_LGA&geoconcept=REGION&datasetASGS=ABS_REGIONAL_ASGS&datasetLGA=ABS_NRP9_LGA&regionLGA=REGION&regionASGS=REGION. Updated March 31, 2017. Accessed April 2, 2019.

6. Australian Bureau Statistics. 2016 Census QuickStats. Australian Bureau Statistics website. https://quickstats.censusdata.abs.gov.au/census_services/getproduct/census/2016/quickstat/LGA35790#cultural. Updated October 23, 2017. Accessed April 2, 2019.

7. Queensland Health. Closing the Gap: Performance Report 2016. Queensland Health website. https://cabinet.qld.gov.au/documents/2017/Mar/ClGapHealth/Attachments/Report.pdf. Published 2016. Accessed April 14, 2019.

8. Palm Island Aboriginal Shire Council. Palm Island Health Action Plan, Health for the People, Health by the People, the Palm Island Way, 2010-2015. Brisbane: State of Queensland; 2011.

9. NACCHO Aboriginal Health News Alerts. Aboriginal sexual health commitment and Investment needed to address syphilis epidemic. NACCHO website. https://nacchocommunique.com/tag/syphilis/. Published 2018. Accessed April 3, 2019.

10. Queensland Health. North Queensland Aboriginal and Torres Strait Islander sexually transmissible infections action plan 2016-2021. Brisbane: state of Queensland (Queensland Health); 2016.

11. YoungDeadlyFree. Infographics – Syphilis. YoungDeadlyFree website. http://youngdeadlyfree.org.au/resources/infographics/. Published 2018. Accessed April 13, 2019.

12. Nicolas Rothwell. Nation's child abuse shame. The Australian. https://www.theaustralian.com.au/news/nation/nations-child-abuse-shame/news-story/798112e01874926411452743f7508ad8. Published June 16, 2007. Accessed June 13, 2019.

13. Nick O’Malley. Wounds of the intervention still run deep in NT's Mutitjulu. The Sydney Morning Herald. https://www.smh.com.au/politics/federal/wounds-of-the-intervention-still-run-deep-in-nt-s-mutitjulu-20190606-p51vbe.html. Published June 8, 2019. Accessed June 13, 2019.

14. Rural Remote Indigenous Tropical Health lecture notes, James Cook University Medical school. Accessed June 13, 2019.

15. NACCHO. NACCHO: History. NACCHO website. https://www.naccho.org.au/about-nacho/naccho-history/. Accessed June 19, 2019.

16. Department of Health. Aboriginal and Torres Strait Islander Health Performance Framework. Canberra 2017: 172.

17. Ong, K. S. et al. ‘Differences in Primary Health Care Delivery to Australia’s Indigenous Population: a Template for Use in Economic Evaluations’, BMC Health Services Research. 2012: 307.

18. Campbell, M.A. et al. Contribution of the Aboriginal Community-Controlled Health Services to Improving Aboriginal Health: an Evidence Review, Australian Health Review. Published March 6, 2017. Accessed June 13, 2019.

19. Misha Ketchell. The new Mabo? $190 million stolen wages settlement is unprecedented, but still limited. The Conversation. https://theconversation.com/the-new-mabo-190-million-stolen-wages-settlement-is-unprecedented-but-still-limited-120162. Accessed July 25, 2019.

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